Estrogen in severe mental illness: a potential new treatment approach.

CONTEXT:

Accumulating evidence suggests that estrogens may have therapeutic effects in severe mental illnesses, including schizophrenia, via neuromodulatory and neuroprotective activity.

OBJECTIVE:

To compare the efficacy of adjunctive transdermal estradiol with that of adjunctive placebo in the treatment of acute psychotic symptoms.

DESIGN:

Randomized, double-blind study.

SETTING:

Patients were recruited from inpatient acute hospital wards and outpatient clinics of 2 metropolitan Melbourne general hospitals.

PARTICIPANTS:

One hundred two women of childbearing age with schizophrenia. All participants were in an acute or chronic phase of their illness; 73 participants were outpatients and the rest were inpatients. Intervention Patients were randomized to receive 100 microg of transdermal estradiol (n = 56) or transdermal placebo (n = 46) for 28 days.

MAIN OUTCOME MEASURES:

Psychopathological symptoms were assessed weekly with the Positive and Negative Syndrome Scale.

RESULTS:

The addition of 100 microg of transdermal estradiol significantly reduced positive (P < .05) and general psychopathological (P < .05) symptoms during the 28-day trial period compared with women receiving antipsychotic medication alone.

CONCLUSION:

Estradiol appears to be a useful treatment for women with schizophrenia and may provide a new adjunctive therapeutic option for severe mental illness.

TRIAL REGISTRATION:

clinicaltrials.gov Identifier: NCT00206570.